Endoscopic features of gastroduodenal Crohn's disease.

The clinical, roentgenographic and endoscopic findings in 14 patients with Crohn's disease of the stomach and/or duodenum are described. To date, this is the largest series of endoscopic findings of Crohn's disease of gastroduodenal region. The endoscopic findings include (1) mucosal nodularity or "cobblestoned" mucosa; (2) multiple aphthous-like ulcerations and/or linear ulcerations; (3) thickening of the antral folds; (4) antral narrowing with evidence of hypoperistalsis; (5) duodenal strictures. The diagnosis of gastric duodenal Crohn's disease is achieved by combining recognition of clinical features and roentgenographic and endoscopic features. The endoscopic features correlate well with the roentgenographic findings in our 14 patients. Tissue for histological diagnosis of Crohn's disease of the gastroduodenal area is rarely obtained by endoscopic biopsy, but peroral suction biopsy specimens may increase the rate of histological confirmation.